"bilateral Factor" Question

[bufloguy]

Hello, I've been reading your forum for a few months and finally decided to register.

On my leaving military service in '91, I was awarded SC bilateral "post traumatic" Plantar Fasciitis at 10%. I have been to the VA hosp for treatment (orthotics & injections) ever since. I had both knees scoped 3 years ago, due to pain (didn't help much). Still have a lot of pain in my knees. The foot dr. suggested that the problems with my knees were most likely caused by the plantar fasciitis, so I filed for the knees as secondary to my sc bilateral Plantar Fasciitis. Long story short. . . I was awarded:

10% Left knee strain, osteoarthitis & 10% Right knee strain, osteoarthitis, but not as secondary to feet, but due to a car accident that occured while I was active duty????

Now my question is . . . What is the Bilateral Factor that I have seen mentioned in this forum? I am SC'd bilatteral for feet @ 10%, why not left and right? Does 10% for both feet sound right? Also, why would the knees be listed as seperate @ 10% and not bilateral? Thanks in advance!

[Ricky]

Most of the foot injures such as yours have two ratings in the regualation: one being a unilateral rating and the other a bilateral rating. If you will tak a look if you receive a bilateral rating for this type of foot injury it will be 10-30 percent more than if rated for just one foot. This is not the same as if you were to receive a rating for the legs, arms etc.... They are only rated as a unilateral item.

Now on your knee ratings. Both require a disability rating. If you get a rating on both then the bilateral factor that you are probably referring to kicks in. What this does is allow for a rating of lets say 10 percent for each knee. Then to give you a bit more because you have a disability in both knees the VA applies section 4.26 to the rating.

4.26 Bilateral factor.

When a partial disability results from disease or injury of both arms, or of both legs, or of paired skeletal muscles, the ratings for the disabilities of the right and left sides will be combined as usual, and 10 percent of this value will be added (i.e., not combined) before proceeding with further combinations, or converting to degree of disability. The bilateral factor will be applied to such bilateral disabilities before other combinations are carried out and the rating for such disabilities including the bilateral factor in this section will be treated as 1 disability for the purpose of arranging in order of severity and for all further combinations. For example, with disabilities evaluated at 60 percent, 20 percent, 10 percent and 10 percent (the two 10's representing bilateral disabilities), the order of severity would be 60, 21 and 20. The 60 and 21 combine to 68 percent and the 68 and 20 to 74 percent, converted to 70 percent as the final degree of disability.

(a) The use of the terms “arms” and “legs” is not intended to distinguish between the arm, forearm and hand, or the thigh, leg, and foot, but relates to the upper extremities and lower extremities as a whole. Thus with a compensable disability of the right thigh, for example, amputation, and one of the left foot, for example, pes planus, the bilateral factor applies, and similarly whenever there are compensable disabilities affecting use of paired extremities regardless of location or specified type of impairment.

(B) The correct procedure when applying the bilateral factor to disabilities affecting both upper extremities and both lower extremities is to combine the ratings of the disabilities affecting the 4 extremities in the order of their individual severity and apply the bilateral factor by adding, not combining, 10 percent of the combined value thus attained.

© The bilateral factor is not applicable unless there is partial disability of compensable degree in each of 2 paired extremities, or paired skeletal muscles.

Edited October 13, 2008 by Ricky